علاج ناسور البنكرياس بعد الجراحة من الدرجة ب مع ألم البطن والحمى وارتفاع مؤشرات الالتهاب

References

DOI: 10.1097/JS9.0000000000001395

• Patients with grade B POPF can present with a variety of nonspecific symptoms including abdominal pain, fever, and increased inflammations index and requires only antibiotic therapy.
• In the clinical practice antibiotic therapy should be started whenever the patient should manifest signs of infection and should be targeted on the basis of cultural isolation data available from both intraoperative bile culture and drain effluent.
• However, since cultural data may not be immediately available in the early postoperative period, a step-up strategy, starting with a broad-spectrum antibiotic subsequently shifted to targeted therapy once the results and the antibiogram are available, should be adopted.
• The position paper of the ISGPS recommends either enteral nutrition (EN) or fasting with total parenteral nutrition (TPN) for patients with B and C grade POPF, and oral feeding for those with a BL.